“No one can force you to have a cesarean” is false

Update: Since this article was originally published, it has been updated with several new resources (listed at the bottom) as well as a video.

 

hospital-bed

 

“No one can force you to have a cesarean.” I see this all the time in message boards.

Don’t worry about

… the VBAC ban

…your unsupportive provider

… your provider’s 40 week deadline

… [insert other VBAC barrier here]

no one can force you to have a cesarean.

That’s just not true.

Let’s start with what is ethical and legal: Yes, no one can legally force you to have a cesarean.

ACOG even says in their latest VBAC guidelines that “restrictive VBAC policies should not be used to force women to undergo a repeat cesarean delivery against their will.” So even if your facility has a VBAC ban, they still cannot force you to have surgery… legally or ethically.

But then you have reality: It happens all the time, but it may look different than you expect.

It’s often NOT a woman screaming “I do not consent” as she is wheeled into the OR, though that has happened.

It’s through lies. It’s through fear.

“The risk of uterine rupture is 25%.”

“Do you want a healthy baby or a birth experience?”

“Planning a VBAC is like running across a busy freeway.”

Hospital policy and provider preference are presented as superseding the woman’s right to decline surgery.

“No one attends VBAC here.”

“It’s against our policy.”

“We don’t allow VBACs.”

Or unreasonable timelines are assigned giving the woman the illusion of choice.

“You have to go into labor by 39 weeks.”

“Your labor can’t be longer than 12 hours.”

“You have to dilate at least 1 centimeter per hour.”

Or it can be a slow process where a seemingly once supportive provider quietly withdraws support exchanging words of encouragement with caution. Dr. Brad Bootstaylor, an Atlanta based OBGYN, describes how this can unfold at 4:00 in this video after a woman describes her experience:

Or, if the birthing parents don’t listen, it can escalate to calling social services, ordering a psychiatric evaluation, or even getting a court order for a forced cesarean.

It can be as simple as, “Your baby is distress.” How do you know if this is true or not? Are you willing to take that risk?

Some people suggest that parents should learn how to interpret fetal heart tones so they can evaluate their baby’s status. But I think this is a wholly unreasonable expectation for non-medical professionals, especially when one is in labor. It is as much an art as it is a science.

In short, coercion frequently isn’t by physical force. It’s through manipulation. This is why it’s worth your time and effort to search for a supportive provider who you trust to attend your birth.

Don’t just think, “Well, I can hire anyone and simply refuse.”

Sometimes it’s not that simple as Rinat Dray, was forced to have a cesarean, and Kimberly Turbin, who received a 12-cut episiotomy while yelling “Do not cut me,” know all too well.

And this is why understanding the complete picture is important. It’s not enough to ponder how things are “supposed to be” or how we want them to be, but how they actually are. The difference between perception and reality is huge. Learn more in my online workshop, “The Truth About VBAC.”

Have you seen a situation like described above play out? Share it in the comment section.

Continue the conversation & share on Facebook here:

There is a huge difference between what is legal, what is ethical, and what actually happens. #forcedcesareans #ethicalvsreality #vbacfacts

Posted by www.VBACFACTS.com on Wednesday, January 6, 2016

 

Learn more:

ACLU. (n.d.). Coercive and punitive governmental responses womens conduct during pregnancy. Retrieved from ACLU: https://www.aclu.org/coercive-and-punitive-governmental-responses-womens-conduct-during-pregnancy

Cantor, J. D. (2012, Jun 14). Court-Ordered Care — A Complication of Pregnancy to Avoid. New England Journal of Medicine, 366, 2237-2240. Retrieved from http://www.nejm.org/doi/full/10.1056/NEJMp1203742?

Hartocollis, A. (2014, May 16). Mother accuses doctors of forcing a c-section and files suit. Retrieved from The New York Times: http://nytimes.com/2014/05/17/nyregion/mother-accuses-doctors-of-forcing-a-c-section-and-files-suit.html?referrer=&_r=0

Human Rights in Childbirth. (2015, Jan 14). Rinat Dray is not alone, Part 1. Retrieved from Human Rights in Childbirth: http://www.humanrightsinchildbirth.org/amicusbriefpart1/

International Cesarean Awareness Network. (n.d.). Your right to refuse: What to do if your hospital has “banned” VBAC. Retrieved from Feminist Women’s Health Center: http://www.fwhc.org/health/pdf_about_vbac.pdf

Jacobson, J. (2014, Jul 25). Florida hospital demands woman undergo forced c-section. Retrieved from RH Reality Check: http://rhrealitycheck.org/article/2014/07/25/florida-hospital-demands-woman-undergo-forced-c-section/

Kamel, J. (2012, Mar 2). Options for a mom who will be ‘forced’ to have a cesarean. Retrieved from VBAC Facts: http://vbacfacts.com/2012/03/02/options-mom-forced-repeat-cs/

Maryland Families for Safe Birth. (2015, Jan 28). The truth about VBAC: Maryland families need access. Retrieved from YouTube: https://youtu.be/C5nymk3IGqE

Paltrow, L. M., & Flavin, J. (2013, April). Arrests of and forced interventions on pregnant women in the United States, 1973-2005: Implications for women’s legal status and public health. Journal of Health Politics, Policy and Law, 38(2), 299-343. Retrieved from http://jhppl.dukejournals.org/content/early/2013/01/15/03616878-1966324.full.pdf+html

Pascucci, C. (2015, Jun 4). Press Release: Woman charges OB with assault & battery for forced episiotomy. Retrieved from Improving Birth: http://improvingbirth.org/2015/06/preview-woman-charges-ob-with-assault-battery-for-forced-episiotomy/

15 thoughts on ““No one can force you to have a cesarean” is false

  1. carla campbell

    I’m 23 weeks pregnant I first saw my doctor at 14 weeks . The nurse was asking my birth history I told her my first birth was a vaginal birth no complications at 37 weeks baby weighing 7pds 8oz 2nd birth 40 weeks mild shoulder dystocia with no complications ( a maneuver was used to allow her shoulders to pass through ) weighing 8 pds 12oz . When the doctor came in the room the first thing he said was I will not be your Doctor unless you agree to get a C-section which I didn’t want I have had both babies no drugs no epidural , so this is clearly against my birth plan. I was clearly upset trying not to cry . I said my baby was fine I’m fine he responded by saying your lucky you both could of died or your baby could be mentally retarded ! I said can we just see how things go ( in my opinion 14 weeks is too early to plan a C-section ) . He said no because your babies are to big and the risks of your baby dying are high ! My previous doctors never said anything like that .I have been trying to find a new doctor but very few accept my insurance . I feel like I have no options and I’m being bullied into to serving the Doctors interest over mine .

    Reply
    1. Jen Kamel Post author

      Hi Carla!

      I am so sorry this is happening to you. Where do you live? Perhaps we can find you more supportive providers in your area. I’ve also posted your comment here to get more feedback.

      Best,

      Jen

      Reply
  2. Joelene Youmans

    You can be forced into a cesarean. I was.

    My first was 7 weeks early due to severe hypertension/toxemia. They induced at 33 weeks and I labored unsuccessfully for days until my liver started failing. This birth ended in emergency cesarean.

    My second, I wanted a VBAC and did my research to find a VBAC friendly doctor who in the end said I had to go into labor by 39 weeks and they would not induce. I felt pressured to induce it naturally any way possible (castor oil, walking, sex) I started having weak contractions most likely caused by the castor oil and “failed to progress”. The doctors convinced me to have a second cesarean after over 12 hours of what I believe now was false labor.

    By my 3rd little one, I was determined to find a truly VBAC friendly doctor. I struggled throughout the pregnancy trying to find one because my 3rd was conceived through a failed IUD and was not expected. I didn’t have the time I needed. I was literally being banned from local doctor practices because of how I felt and what I wanted. I have a letter from multiple different doctors telling me they were discharging me from their care because I wanted VBAC. I finally settled with a clinic out of the hospital who my first OB had rights to and who performed my first cesarean. It was 2 hours from where I lived. But they had anesthesiologists on site at all times for “in case” an emergency arose.

    My water broke 10 days after my due date. Nearing my due date the doctor who seemed so confident in the VBAC began telling me the baby looked too large to be born naturally. My research said that’s one excuse they will use to encourage cesarean so I ignored him. I rode 2 hours in a cab to this hospital I planned to give birth in with water leaking and contracting.

    I got there around noon and they hooked me up to the monitors and began the epidural (their procedure “in case” something goes wrong) Not much longer they were insisting the baby was in distress but that we couldn’t see it because the monitors weren’t picking it up right because of his position. I told them he seemed fine but they convinced my mother he wasn’t and that he needed a cord attached to his scalp to read his vitals. They basically got the go ahead to hold me down and insert it into me and onto him through my mother. I was of age and married! I was kicking and screaming, alarmed I was being held down against my will. My heart was racing. Once it was in they said the baby was definitely in distress and he had to be born RIGHT NOW. Like I couldn’t see his heart rate or didn’t know that the numbers were normal. They wheeled me in quite literally screaming, “I don’t need a c-section!” Injected me with something that knocked me out until half way through the “birth”. Still groggy I awoke to my mom excited over his size but puzzled by the incision. She noticed before I did and asked the nurse why was the line up and down? The nurse said, “Well, that’s so she can never try for VBAC again.” Just nonchalantly, like that’s what they do everyday!

    So, please, if you think you can’t be forced into a cesarean, think again! You can, as this article states, either by manipulation and twisted facts, playing on a mother’s love for her child and its safety or quite literally, physically and forcefully you may end up in OR because others intervene and think they know what’s best for you and YOUR baby.

    Reply
  3. Jenna

    I had my first cs at 19 years old after a failed induction at 40 weeks. My second was a planned RCS, because I was told vbac was 50/50 chance and I didn’t think those odds were very good. In my 3rd pregnancy the ob told me no way when I asked about vbac, and my fourth pregnancy the ob said my baby or I would die in a trial of labor. I finally learned to do my own research and have gone on to have four vba3c out of the hospital with supportive midwives. That was 3 unneccessary cs and 4 successful vbacs that would not have happened without supportive providers. I was coerced into believing what they told me and though I was a “lucky” one without complications, who knows what might have happened if I had believed the lies and continued to have cs. Thank you for supporting women and researching for us!!

    Reply
  4. Shirley

    Honestly I see things in what I say is a more well rounded and unbiased view. I am a Labor and Delivery nurse, who is very supportive of home births. I work in a hospital that has a C-section rate of 18% or less, I have seen many “provider” c-sections, as well as many true emergencies that are often the result of patients refusing them, I have seen babies born damn near close to death, with the most wonderful tracing, and babies with shitty tracing coming out all pretty. Bottom line is that you need to research your provider to death! you need to know what to ask, and most importantly every single mother needs to educate herself on what a c-section entails and what are reasons given for c-sections. ALL mothers! Half the trauma comes from patients that do not know what to expect, both from vaginal and C-sections. VBAC’s at my hospital is the norm. They are almost always encouraged.

    All that said, C-sections can be forced, mostly because patients are so vulnerable at the time, that even educated patients that are told their baby isnt doing well will often go will it. But education, and research pays of, and I often encourage patients in that direction! (without giving recommendations)

    Reply
    1. Madi

      Hi, so how can we tell if they’re lying about how the baby is doing? What should we ask? Or say?… I had 2 previous Cs & I want this last baby birth to be a VBAC & I’ve heard of all this crap doctors r doing & saying to prevent u from doing it the way u want to. And of course, all the info I try to find, u hv to pay to get it. The place I’m going is called The Birth Place where they support VBAC but they’ll send me to the hospital whenever is time bcz they’re midwife & I won’t meet the doctor til I’m about 32 weeks. It’s a lil scary bcz this doctor might tell me something else at the hospital after all my hopes hv bn raised at The Birth Place. So, I was reading about this & it said that unless the baby or myself or not in danger, we can deny the Cs. The question is, what to ask to see prove if they tell u that the baby is going through stress & a Cs is necessary???

      I’m 5 mth prego

      Reply

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